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Malignant tumors, characterized by uncontrolled cell proliferation, are a leading global health challenge, responsible for over 9.7 million deaths in 2022, with new cases expected to rise to 35 million annually by 2050. Immunotherapy is preferred to other cancer therapies, offering precise targeting of malignant cells while simultaneously strengthening the immune system's complex responses. Advances in this novel field of science have been closely linked to a deeper knowledge of tumor biology, particularly the intricate interplay between tumor cells, the immune system, and the tumor microenvironment (TME), which are central to cancer progression and immune evasion. This review offers a comprehensive analysis of the molecular mechanisms that govern these interactions, emphasizing their critical role in the development of effective immunotherapeutic products. We critically evaluate the current immunotherapy approaches, including cancer vaccines, adoptive T cell therapies, and cytokine‐based treatments, highlighting their efficacy and safety. We also explore the latest advancements in combination therapies, which synergistically integrate multiple immunotherapeutic strategies to overcome resistance and enhance therapeutic outcomes. This review offers key insights into the future of cancer immunotherapy with a focus on advancing more effective and personalized treatment strategies. [ABSTRACT FROM AUTHOR]

Malignant (high-grade) gliomas are aggressive intrinsic brain tumors that diffusely infiltrate the brain parenchyma. They comprise of World Health Organization (WHO) grade III and IV gliomas. Ionizing radiation or irradiation (IR) is frequently utilized in the treatment of both primary as well as metastatic brain tumors. On the contrary, macrophages (MΦ) are the most copious infiltrating immune cells of all the different cell types colonizing glioma. MΦ at tumor milieu are referred to as tumor-associated macrophages (TAMΦ). In malignant gliomas milieu, TAMΦ are also polarized into two distinct phenotypes such as M1 TAMΦ or M2 TAMΦ, which are capable of inhibiting or promoting tumor growth, respectively. Cranial-IR such as x- and γ-IR are sufficient to induce the migration of peripherally derived MΦ into the brain parenchyma. The IR facilitate a more immunosuppressive milieu via the stimulation of efferocytosis in TAMΦ, and an upsurge of tumor cell engulfment by TAMΦ exhibited detrimental effect of the anti-tumoral immune response in glioma. The MΦ inside the tumor mass are associated with multiple phenomena that include IR resistance and enrichment of the M2 MΦ after IR is able to facilitate glioblastoma multiforme (GBM) recurrence. Reviews on the role of cranial IR-induced peripheral and brain-engrafting macrophages (BeMΦ) in glioma are lacking. Specifically, most studies on peripheral, intrinsic as well as beMΦ on IR focus on WHO grade III and IV. Thus, this review precisely focuses primary on WHO grade III as well as IV gliomas. [ABSTRACT FROM AUTHOR]

Introduction: Oral malignant melanoma (OMM) is the most common malignant oral neoplasm in dogs. Tumor recurrence, progression, and regional and distant metastasis remain major obstacles despite advanced therapy. Tumor size has been a consistent, key independent prognostic factor; however, other clinical and histopathologic features impact prognosis and likely influence optimal treatment strategies. Adoption of a risk stratification scheme for canine OMM that stratifies groups of dogs on defined clinicopathologic features may improve reproducible and comparable studies by improving homogeneity within groups of dogs. Moreover, it would aid in the generation of multidisciplinary prospective studies that seek to define optimal treatment paradigms based on defined clinicopathologic features. Methods: To build a platform upon which to develop a risk stratification scheme, we performed a systematic review of clinicopathologic features of OMM, with particular attention to levels of evidence of published research and the quantitative prognostic effect of clinicopathologic features. Results: Tumor size and presence of bone lysis were repeatable features with the highest level of evidence for prognostic effects on survival. Overall, with strict inclusion criteria for paper review, the levels of evidence in support of other, previously proposed risk factors were low. Factors contributing to the challenge of defining clear prognostic features including inconsistencies in staging and reporting of prognostic variables, incomplete clinical outcome data, inhomogeneous treatment, and absence of randomized controlled studies. Discussion: To overcome this in the future, we propose a risk stratification scheme that expands the TNM system to incorporate specific designations that highlight possible prognostic variables. The ability to capture key data simply from an expanded TNM description will aid in future efforts to form strong conclusions regarding prognostic variables and their influence (or lack thereof) on therapeutic decision-making and outcomes. [ABSTRACT FROM AUTHOR]

Background: Cancer has been regarded as the most dreaded disease for both human and animals because of its incurability. Canine mammary tumours are common and major problem encountered by academicians and practicing veterinarians. As a result, the current study was conducted to examine the effectiveness and overall impact of different surgico-chemotherapeutic approaches in treating malignant mammary tumors in dogs. Methods: The investigation involved 18 clinical instances of mammary tumors in different breeds, regardless of age or sex and were divided into three groups of six animals each. In Group S, only surgical excision of tumour was performed while animals of Group SD and Group SV were treated with surgical excision followed by administration of Doxorubicin (30 mg/m2) BSA and Vincristine sulphate (0.025 mg/kg) intravenously alongwith DNS at 7th and 14th post-operative days respectively. Different physiological and haemato-bichemical parameters i.e. Hb, PCV, TLC, TPC, DLC, Serum glucose, TSP, SUN, SC, ALT, AST and ALP were recorded preoperatively, postoperatively and following chemotherapy at 10th, 30th and 60th day intervals. Result: The present study showed transient change in the physiological, haematological and biochemical profiles following surgery and chemotherapy treatment. The histopathological analysis showed more cases of adenocarinoma which were followed by mixed carcinoma. Surgery combined with chemotherapy (doxorubicin and vincristine) resulted in minimal to no reoccurrence with few adverse reactions including inappetance, vomition, anaemia and alopecia. It was concluded that the most effective treatment for malignant mammary tumors in dogs is surgical excision followed by sequential vincristine therapy, which efficiently regresses the tumor without causing relapse. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid disorders are common in Indian adult population. Current management guidelines from the American Thyroid Association (ATA) recommend diagnostic ultrasonography for all patients with thyroid nodules. However, suspicious and few overlapping characteristics of benign and malignant thyroid nodules makes FNAC unquestionable. Unwanted suspicion leads to excessive unnecessary biopsies and insufficient lower suspicion leads to under-diagnosis or missing of thyroid malignancies. Hence, making accurate decision of whether a nodule is potentially malignant or not is crucial. Aims and objectives: To study the USG features of thyroid lesions in patients with thyroid disorders and correlate these USG findings with FNAC in the diagnosis of thyroid lesions. Methods: The cross-sectional study was done for 18 months among patients of thyroid disorders coming to the Radio-diagnosis department of Muzaffarnagar Medical College for routine USG scan for thyroid lesions. A sample of 50 patients was taken among the age group of 10-75years who gave consent for FNAC and did not have any bleeding disorders. Sonographic evaluation of the thyroid gland was done by characterising its size, shape, echogenicity, vascularity and presence or absence of nodules. The respective nodules were assed for suspicious patterns and FNAC of the nodules was done to correlate the radiological with pathological diagnosis. Results: As per the study, with good sensitivity and specificity, radiological examination of thyroid lesions by USG showed significant correlation with pathological evaluation of thyroid lesions by FNAC examination. A strong positive correlation between the two diagnostic procedures was seen. The correlation was statistically significant, with a P < 0.05. Conclusion: Thyroid gland ultrasound is a non-invasive, cost-effective and patient compliant technique in assessing and diagnosing thyroid swellings which can be performed as the initial investigation before FNAC examination for quickly assessing thyroid nodules, their vascularity and identifying benign from malignant lesions. This would avoid unnecessary invasion and its related complications like puncturing an highly vascular nodule which could be determined on USG itself. [ABSTRACT FROM AUTHOR]

Background: In India, breast carcinoma is the 2nd most common malignancy in women. Incidence increases every year which ranges approximately 20-32%. Incidence of breast cancer shows "AGE SHIFT" over the past twenty years in India that is incidence increased from 6 to 17% in the age group of 30-40 years. The 'Modified Triple Test' utilizes-Physical Examination, Ultrasonography of the breast as the radiological method, and FNAC for the diagnosis of palpable breast lumps. It is gaining acceptance with the recent advances in technology and refinements in the interpretative criteria of sonographically characterized masses. Methods A prospective cross sectional study of 50 female patients attending the out patient department of General Surgery, K.R. Hospital, Mysore, between March 2022 to January 2024, with the complaint of a palpable lump/lumps in the breast was undertaken. Results Most commonly affected age group being 30-39 years. Incidence increased from 7 to 16% between the age group of 30 and 40 years. The calculated P - value for parity study is 0.017 and it is shown that malignancy is common among nulliparous. For the menstrual status, the calculated p-value is 0.044 is significant. The breast tumor is common at left side account for about overall 54% age. Fibroadenoma is the most common benign tumor. It was inferred from the study that clinical examination has a sensitivity of 87.5% which means that around 12.5% of the breast carcinoma cases are missed clinically. Results of Modified Triple Test were Sensitivity: 100%, Specificity: 97.37%, PPV: 91.67%, NPV: 100%. Hence the modified triple test can be used as a reliable and fairly accurate means of diagnosis of breast carcinoma. Conclusion Our results show that the diagnostic accuracy of physical examination breast USG and FNA/CNB combined is comparable to that of histological examination. Ultrasound replacing mammography serve as an effective imaging modality in palpable breast lumps and is also more comprehensive. CNB is a suitable alternative when FNA is inconclusive, also offers additional information. Thus the use of MTT to complement findings in differential diagnosis of a lesion in a symptomatic women seeking medical care deserves acceptance and further evalution. [ABSTRACT FROM AUTHOR]

Introduction: Head and neck malignancies are associated with poor prognosis and poor quality-of-life if detected late. Narrow-Band-Imaging(NBI) is one of the important tools, which helps in detecting these lesions earlier. By using narrow-wavelength(400–550 nm) it enhances the mucosal and submucosal vascularity against the pale mucosal background which helps us detecting benign, pre-malignant and malignant lesions. Objective: The objective of this study was to evaluate the accuracy of NBI in the diagnosis of various mucosal lesions of head and neck region and its correlation with the histopathology reports. Materials and Methods: This was a prospective diagnostic study conducted between June 2020 - June 2022 where 118 patients(oral cavity-28, laryngeal-87,and hypopharyngeal-3) who fulfilled the inclusion and exclusion criteria were recruited. All-118-patients underwent NBI endoscopy under local/general anaesthesia followed by biopsies from the most suspicious-areas. Type of vascular-pattern noted from NBI and their respective histopathological reports were correlated. Results: The mean age was 53.28 ± 1.24 years ranging from 16 to 88 years. The sensitivity, specificity, Positive-Predictive-Value(PPV) and Negative-Predictive-Value(NPV) in detecting benign lesions were 100%, 90%, 74% and 100% respectively. The sensitivity, specificity, PPV and NPV in detecting premalignant lesions were 70%, 92%, 56% and 96% respectively. The sensitivity, specificity, PPV and NPV in detecting malignant lesions were 83%,97.5%, 98.5% and 97.5% respectively. NBI has a strong association with the histopathological reports, which is statistically significant(p-value < 0.001). Conclusion: NBI has high specificity and negative predictive value in detecting and classifying various mucosal lesions of head-neck region. Its findings had a strong correlation with histopathological reports. [ABSTRACT FROM AUTHOR]

The leading cause of cancer-related deaths worldwide is skin cancer. Effective therapy depends on the early diagnosis of skin cancer through the precise classification of skin lesions. However, dermatologists may find it difficult and time-consuming to accurately classify skin lesions. The use of transfer learning to boost skin cancer classification model precision is a promising strategy. In this work, we proposed a hybrid CNN with a transfer learning model and a random forest classifier for skin cancer disease detection. To evaluate the efficacy of the proposed model, it was verified over two datasets of benign skin moles and malignant skin moles. The proposed model is able to classify images with an accuracy of up to 90.11%. The empirical results and analysis assure the feasibility and effectiveness of the proposed model for skin cancer classification. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze the independent risk factors of malignant subpleural pulmonary lesions (SPLs) on B-mode ultrasound (US) images, to construct the combined predictive indicators, and to prospectively verify their predictive efficacy. A total of 336 patients with SPLs were included in the prospective study, of whom the single-center included patients between September 2019 and December 2019 were the development cohort (DC) (n = 219); Patients who were concurrently enrolled in three centers between January and February 2020 were the validation cohort (VC) (n = 117). The clinical features and B-mode US parameters were collected. Based on the DC, a combined predictive indicators model was developed using binary logistic regression. Then the discrimination was verified externally in the VC. The reference criteria were from the comprehensive diagnosis of clinical-radiological-pathological made by two senior respiratory physicians. The combined predictive indicators model was finally constructed by five parameters: age, borderline, angle between the lesion border and thoracic wall, posterior echo of the lesion and invasion of the pleura. The fitting degree of the model was good (χ 2 = 9.198, p = 0.326). The area under ROC curve of the model was 0.872 (DC) and 0.808 (VC), yielding a higher net benefit than individual risk factors. The combined predictive indicators are useful in the assessment of malignant SPLs and are a useful adjunct diagnostic tool, especially in primary healthcare settings in developing countries. [ABSTRACT FROM AUTHOR]

This review covers data on the role of reduced extracellular pH (acidosis) in tumor tissue in the development of tumorigenesis. The following processes characterizing the malignant phenotype of the tumor are considered: (1) protease activation causing destruction of the intercellular matrix and disruption of intercellular interactions, which makes invasion and metastasis possible; (2) genome instability; (3) inhibition of the antitumor immune response; (4) activation of exosome synthesis, which plays an important role in intercellular communications and is involved in the formation of "premetastasis niches"; and (5) P-glycoprotein activation and a number of other processes associated with the formation of the malignant tumor phenotype. It is concluded that acidosis plays a leading role in the realization of these malignant tumor properties. The role of pH-sensors in transmitting information about the pH value of the extracellular environment (its acidity) inside the cell is described. The possibility of the leading role of acidosis at the earliest stages of tumor process in overcoming the regulatory action of surrounding normal cells is also described. The therapeutic effect of many antitumor drugs depends on the pH value of the medium in which they act. In this regard, the role of acidosis in the action of various preparations for chemotherapy and the possibility of influencing tumor acidosis in order to enhance the antitumor activity of substances are further discussed. [ABSTRACT FROM AUTHOR]

Skin cancer (SC) is a lethal disease not only in India but also in the world; there are more than a million cases of melanoma per year in India. Early detection of skin cancer through accurate classification of skin lesions is essential for effective treatment. Visual inspection by clinical screening, dermoscopy, or histological tests is strongly emphasised in today's skin cancer diagnosis. It can be challenging to determine the kind of skin cancer, especially in the early stages, due to the resemblance among cancer types. However, the precise classification of skin lesions could be time-consuming and challenging for dermatologists. To address these issues, we propose transfer learning to accurately classify skin lesions into several forms of skin cancer using a lightweight B-16 Vision Image Transformer model (LViT). An extensive dataset is used in the experiment to verify the efficiency of the proposed LViT model. The LViT model can classify skin cancer with high accuracy, sensitivity, and specificity and generalise favourably to new images. The proposed model has a 93.17% accuracy rating for classifying SC images over 25 epochs and a remarkable accuracy of 95.82% over 100 epochs. The proposed LViT model is lightweight, requires minimal processing resources, and achieves good accuracy on small and enormous data sets. [ABSTRACT FROM AUTHOR]

Globally, breast cancer is the leading cause of mortality for women. It has had an impact on the lives of all individuals, regardless of gender—males, females, and transgender people. However, it is more common among women. Its fatality rate can be decreased with early discovery and treatment. Machine Learning (ML) is critical to the early detection of breast cancer. ML's use has grown in a variety of fields during the last decade. Analytical modelling with ML is mostly restricted to statistical approaches such as image recognition, resonance spectroscopy, and mass spectrometry. This study gives an in-depth look at breast cancer and the many ML approaches used to identify it. A thorough examination of breast cancer diagnosis using machine learning is provided, comprising classification, prediction, and detection. Technical concerns with present prediction models and measuring methods (used to determine how active malignant and healthy tissues are) are highlighted to make future recommendations. [ABSTRACT FROM AUTHOR]

The current primary treatment approach for malignant pelvic tumors involves hemipelvic prosthesis reconstruction following tumor resection. In cases of Enneking type II + III pelvic tumors, the prosthesis necessitates fixation to the remaining iliac bone. Prevailing methods for prosthesis fixation include the saddle prosthesis, ice cream prosthesis, modular hemipelvic prosthesis, and personalized prosthetics using three-dimensional printing. To prevent failure of hemipelvic arthroplasty protheses, a novel fixation method was designed and finite element analysis was conducted. In clinical cases, the third and fourth sacral screws broke, a phenomenon also observed in the results of finite element analysis. Based on the original surgical model, designs were created for auxiliary dorsal iliac, auxiliary iliac bottom, auxiliary sacral screw, and auxiliary pubic ramus fixation. A nonlinear quasi-static finite element analysis was then performed under the maximum load of the gait cycle, and the results indicated that assisted sacral dorsal fixation significantly reduces stress on the sacral screws and relative micromotion exceeding 28 μm. The fixation of the pubic ramus further increased the initial stability of the prosthesis and its interface osseointegration ability. Therefore, for hemipelvic prostheses, incorporating pubic ramus support and iliac back fixation is advisable, as it provides new options for the application of hemipelvic tumor prostheses. [ABSTRACT FROM AUTHOR]

Background: Cervical malignancy is a serious global public health issue that affects women and major cause of death in low and middle-income nations. Even when using cisplatin-based combination therapy, individuals with severe or recurring illness have a poor prognosis, Therefore, there is a growing need to identify new therapeutic targets that can supplement or replace the present treatment for these individuals. Objectives: To study the expression of HER-2/neu biomarker in premalignant and malignant epithelial lesions of uterine cervix and its correlation with general clinical parameters and histological type, grade, and tumor stage. Material and methods: A cross-sectional study was conducted on 72 histologically diagnosed cases of premalignant and malignant epithelial lesions of uterine cervix in 1 year. Detailed gross and microscopic examination followed by HER-2/neu immunostaining was performed in all cases. Results: Out of 72 cases of cervical lesions, premalignant were 9 in number whereas 63 cases were malignant. HER-2/neu expression was noted in 21 cases (29.2 %) out of 72 cases. Higher HER-2/neu expression intensity (2+ and 3+) was seen in malignant lesions (17.5 %, n=11) than in premalignant lesions (11.1 %, n=1). In comparison to well-differentiated SCC (n=2), the percentage of lesions with higher expression (2+ and 3+ scores) was considerably higher in poorly and moderately differentiated groups (n=8). HER-2/neu expression intensity increases with the advancement of clinical stage of malignant cervical lesions. Conclusion: Over-expression of HER-2/neu biomarker is associated with poor prognosis and aggressive behavior of premalignant and malignant cervical lesions. [ABSTRACT FROM AUTHOR]

Meckel's cave is a dural recess in the posteromedial portion of the middle cranial fossa, serving as a conduit for the trigeminal nerve and hosting various pathologies. The radiological diagnosis of Meckel's cave pathologies is often challenging, especially when they are atypical and rarely encountered. Here, we discuss the case of a 41-year-old woman who presented with right hemifacial pain, numbness, and binocular diplopia. Imaging features suggested a T2 hypointense, T1 hyperintense, and nonenhancing mass in the right Meckel's cave. Intraoperatively, an extra-axial black mass was observed, suggestive of melanoma, which was radically excised. Further postoperative workup and biopsy revealed it was a primary central nervous system (CNS) malignant melanoma, an exceedingly rare condition. Due to the rarity of the disease, a consensus regarding treatment regimens is lacking. This case report underscores the significance of considering uncommon diagnoses when faced with unusual radiological findings and emphasizes the importance of aggressive surgical resection and the evolving landscape of adjuvant treatments for primary CNS melanomas. [ABSTRACT FROM AUTHOR]

Summary: Breast cancer is the most prevalent kind of tumor to occur in females and the primary cause of death for women. Early detection is perhaps the most successful strategy to minimize breast cancer mortality. Early diagnosis necessitates a consistent and efficient diagnostics method that allows doctors to differentiate benign from malignant breast cancers without a surgical sample. The goal of this endeavor is to develop a sophisticated breast cancer diagnosis method. The primary goal of the paper is to reduce the death rate among women by promoting early detection of breast cancer. First, pre‐processing techniques such as median filtering and contrast limiting adaptive histogram equalization are used to the obtained raw images. By doing this, the machine‐learning model's computational complexity is decreased and the image quality is enhanced. K‐means clustering is used to segregate the pre‐processed image. Additionally, features including the enhanced local vector pattern, grey‐level co‐occurrence matrix and local vector patterns are produced in the course of the feature extraction stage. Finally, an optimized deep belief network (DBN) is carrying out the classification process. To boosts the classification accuracy, activation function of DBN (tanh, softmax, ReLu) as well as its weight function is optimized by the proposed grey wolf updated whale optimization algorithm The accuracy of the greywolf updated whale optimization algorithm+DBN is above 93% for datasets 1 and 2 when compared to extant models. Finally, calculation of the performance validates the proposed model's performance. [ABSTRACT FROM AUTHOR]

WHO Grade 3 (G3) meningiomas are rare tumours with limited data to guide management. This retrospective study documents UK management approaches across 14 centres over 11 years. Patients with WHO G3 meningioma between 01/01/2008 and 31/12/2018 were identified. Data were collected on demographics, management strategy, adjuvant radiotherapy, approach in recurrence setting and survival. 84 patients were identified. 21.4% transformed from lower-grade disease. 96.4% underwent primary surgical resection, with 20.8% having evidence of residual disease on their post-op MRI. 59.3% of patients underwent adjuvant radiotherapy (RT) following surgical resection. Overall median PFS and OS were 12.6 months and 28.2 months, respectively. Median OS in the group who underwent complete surgical resection was 34.9 months, compared to 27.5 months for those who had incomplete resection (HR 0.58, 95% CI 0.27–1.23, p = 0.15). Median OS was 33.1 months for those who underwent adjuvant RT and 14.0 months for those who did not (HR 0.48, 95% CI 0.27–0.84, p = 0.004). Median adjuvant RT dose delivered was 60Gy (range 12Gy–60Gy), 45.8% of adjuvant RT was delivered using IMRT. At disease relapse, 31% underwent salvage surgery and 29.3% underwent salvage RT. Of those treated with salvage RT, 64.7% were re-treats and all were treated with hypofractionated RT. Surgery continues to be the preferred primary management strategy. Post-operative MRI within 48 hours is indicated to assess presence of residual disease and guide further surgical options. Adjuvant radiotherapy plays an important part of the management paradigm in these patients with the data supporting an attached survival advantage. Further surgery and re-irradiation is an option in the disease recurrence setting with radiosurgery frequently utilised in this context. • Surgical resection remains primary management strategy. • Post-operative MRI important to assess resection status and role of further surgery. • Data suggests adjuvant radiotherapy provides survival advantage. • Radiosurgery frequently used in the re-irradiation setting. • Associated with poor PFS (median 12.6 months) and OS (median 28.2 months). [ABSTRACT FROM AUTHOR]

Background: Breast cancer, a genetically intricate disease with diverse subtypes, exhibits heightened incidence globally. In this study, we aimed to investigate blood-based microRNAs (miRNAs) as potential biomarkers for breast cancer. The primary objectives were to explore the role of miRNAs in cancer-related processes, assess their differential expression between breast cancer patients and healthy individuals, and contribute to a deeper understanding of the molecular underpinnings of breast cancer. Methods: MiRNA extraction was performed on 40 breast cancer patients and adjacent normal tissues using a commercial RNA isolation kit. Total RNA quantification and quality assessment were conducted with advanced technologies. MiRNA profiling involved reverse transcription, labeling, and hybridization on Agilent human miRNA arrays (V2). Bioinformatics analysis utilized the DIANA system for target gene prediction and the DIANA-mirPath tool for pathway enrichment analysis. Selected miRNAs underwent validation through quantitative real-time PCR. Results: Principal component analysis revealed overlapping miRNA expression patterns in primary and malignant breast tumors, underscoring the genetic complexity involved. Statistical analysis identified 54 downregulated miRNAs in malignant tumors and 38 in primary tumors compared to controls. Bioinformatics analysis implicated several pathways, including Wnt, TGF-b, ErbB, and MAPK signaling. Validation through qRT-PCR confirmed altered expression of hsa-miR-130a, hsa-miR-21, hsa-miR-223, and hsa-let-7c key miRNAs, highlighting their significance in breast cancer. The results from microarray were further validated by qPCR and the expression of which are downregulated in breast cancer was detected. Conclusion: This study provides significant insights into distinct miRNA expression patterns in normal and malignant breast tissues. The overlapping miRNA profiles in primary and malignant tumors underscore the complexity of genetic regulation in breast cancer. The identification of deregulated miRNAs and affected pathways contributes to our understanding of breast cancer pathogenesis. The validated miRNAs hold potential as diagnostic and prognostic markers, offering avenues for further clinical exploration in breast cancer research. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to compare shear wave elastography (SWE) of benign and malignant breast lesions, evaluate the sensitivity and specificity of previously suggested thresholds for identifying malignant breast lesions, and compare SWE measures across histopathological type and grade. Methods: This single‐centre study included 303 patients, and 405 solid breast lesions were biopsied and evaluated by mammography, which may have included contrast‐enhanced mammography, conventional B‐mode ultrasound, and SWE. Following this, elastography mean (Emean), maximum (Emax), and ratio (Eratio) variables were calculated for elasticity in kilopascals (kPa) and speed in metres per second (m/s). Results: Malignant (n = 113) samples were significantly higher than benign (n = 267) across all SWE variables [median (interquartile range)]; Emean (kPa) [132.8 (34), vs. 41.9 (53.6), p <.001], Emean (m/s) [6.9 (1), vs. 3.7 (2.2), p <.001]. The highest combined sensitivity and specificity were for Emax (97%, 73%) at >80 kPa, and Emean (96%, 76%) at >5.2 m/s. Histopathological grade 3 (kPa), Emean [145.8 (22.5), p =.012], Emax [147.8 (19.4), p =.009], and Eratio [11.7 (6.6), p =.006] were significantly higher than grades 1 [129.2 (37.3), 133.2 (35.9), 7.53 (4.7)] and 2 [127.3 (36.4), 133.3 (34.2), 8.3 (6.1)]. Conclusion: Breast elastography is a sensitive complementary technique that can distinguish between malignant and benign lesions and help characterise histological profile and grade. [ABSTRACT FROM AUTHOR]

Angiomyolipoma (AML) is a neoplasm within the perivascular epithelioid cell tumor family that occurs somewhat frequently in the kidney. Most are indolent and discovered incidentally, with rare tumors demonstrating malignant clinical behavior. A small subset of renal AMLs with epithelioid features are associated with aggressive behavior, and may demonstrate morphologic overlap with renal cell carcinomas (e.g., clear cell renal cell carcinoma (RCC), TFE3-rearranged RCC). Prior studies of spindle cell and epithelioid AMLs have identified rare examples with underlying TFE3 gene fusions. TFE3 protein expression (demonstrated by immunohistochemistry) with no evidence of concurrent TFE3 rearrangements has been reported previously in 4/24 AMLs (17%) (Argani et al. Am J Surg Pathol 34:1395-1406, 2010). Currently, the relationship between TFE3 protein expression, TFE3 fusions, and expression of TFE3-mediated genes remains incompletely understood in renal epithelioid AMLs. We sought to explore these relationships using TFE3 break-apart fluorescence in situ hybridization (FISH) and TRIM63 RNA in situ hybridization (ISH) on epithelioid AMLs with moderate to strong TFE3 expression by immunohistochemistry. RNA sequencing (fusion panel) was performed on two cases with negative FISH results to assess for FISH-cryptic gene fusions. The series comprised five epithelioid AMLs from four patients (three women, one man) aged 13 to 76 years. All were considered positive for TFE3 by immunohistochemistry (2 + /3 + expression). TRIM63 ISH was performed on four specimens from three patients, yielding positive results in 3/3 tumors (100%) that were successfully analyzed. TFE3 break-apart FISH was performed on all samples, demonstrating a TFE3 rearrangement in only 1/4 tumors (25%). RNA sequencing demonstrated the absence of productive TFE3 gene fusions in three tumors with negative break-apart TFE3 FISH results. This study demonstrates that renal epithelioid AMLs overexpress TFE3 and TFE3-mediated genes (TRIM63) even in the absence of TFE3 rearrangements. This finding could be explained by functional upregulation of TFE3 secondary to activation of the mammalian target of rapamycin complex 1 (mTORC1). Expression of TFE3 and TRIM63 in this tumor type represents a potential pitfall, given the morphologic and immunophenotypic overlap between epithelioid AML and TFE3-altered renal cell carcinoma. [ABSTRACT FROM AUTHOR]

Background: Category III (AUS; Atypia of Undetermined Significance) of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was established to describe thyroid nodule features that are neither benign nor cancerous. OBJECTIVES: This study aims to evaluate the rate of thyroid malignancy in patients diagnosed with AUS at the Armed Forces Hospital Southern Region (AFHSR), Saudi Arabia. Method: The patients (508) diagnosed with AUS in their thyroid nodules underwent fine-needle aspiration cytology (FNAC). Data were collected through a chart-based approach, reviewing patients’ medical records and relevant information. Results: Among the cases, the majority were females (84.6%). Among the different age groups, individuals between 40 and 50 years had the highest prevalence of thyroid nodules (32.5%). Approximately 27% of patients exhibited tumor sizes larger than 4 cm. FNAC results revealed 16.5% benign, 26% AUS, and 22.4% follicular neoplasm cases. Histopathology indicated 54.1% of benign and 37.2% of malignant cases. Papillary carcinoma accounts for 80.4% of all malignant cases. A significant correlation was observed between FNAC and postoperative histopathology (P value < 0.05). Hypoechoic nodules exhibited 33.9% of malignant cases, and calcification was observed in 25% of the cases. A significant association was found between malignancy and echogenicity and between malignancy and calcification (P value = 0.003 and 0.001, respectively). Conclusion: The findings of this study identify malignancy in thyroid nodules with AUS cytopathology, particularly in the Southern region of Saudi Arabia. The correlation between pre-surgery FNAC and postoperative histopathology supports FNAC’s diagnostic value. Additionally, echogenicity and calcification can potentially contribute to predicting nodule malignancy.

Abstract The current primary treatment approach for malignant pelvic tumors involves hemipelvic prosthesis reconstruction following tumor resection. In cases of Enneking type II + III pelvic tumors, the prosthesis necessitates fixation to the remaining iliac bone. Prevailing methods for prosthesis fixation include the saddle prosthesis, ice cream prosthesis, modular hemipelvic prosthesis, and personalized prosthetics using three-dimensional printing. To prevent failure of hemipelvic arthroplasty protheses, a novel fixation method was designed and finite element analysis was conducted. In clinical cases, the third and fourth sacral screws broke, a phenomenon also observed in the results of finite element analysis. Based on the original surgical model, designs were created for auxiliary dorsal iliac, auxiliary iliac bottom, auxiliary sacral screw, and auxiliary pubic ramus fixation. A nonlinear quasi-static finite element analysis was then performed under the maximum load of the gait cycle, and the results indicated that assisted sacral dorsal fixation significantly reduces stress on the sacral screws and relative micromotion exceeding 28 μm. The fixation of the pubic ramus further increased the initial stability of the prosthesis and its interface osseointegration ability. Therefore, for hemipelvic prostheses, incorporating pubic ramus support and iliac back fixation is advisable, as it provides new options for the application of hemipelvic tumor prostheses.

BACKGROUND: Tumor Treating Fields (TTFields) is a non-invasive modality for cancer treatment that utilizes a specific sinusoidal electric field ranging from 100 kHz to 300 kHz, with an intensity of 1 V/cm to 3 V/cm. Its purpose is to inhibit cancer cell proliferation and induce cell death. Despite promising outcomes from clinical trials, TTFields have received FDA approval for the treatment of glioblastoma multiforme (GBM) and malignant pleural mesothelioma (MPM). Nevertheless, global acceptance of TTFields remains limited. To enhance its clinical application in other types of cancer and gain a better understanding of its mechanisms of action, this review aims to summarize the current research status by examining existing literature on TTFields clinical trials and mechanism studies. CONCLUSIONS: Through this comprehensive review, we seek to stimulate novel ideas and provide physicians, patients, and researchers with a better comprehension of the development of TTFields and its potential applications in cancer treatment.

Introduction: The ovaries, fallopian tubes, and the broad ligament make up the anatomical adnexa. Adnexal masses represent a commonly occurring issue in gynaecology. The majority of ovarian malignancies are detected at advanced stages. The clinical manifestations of adnexal masses vary, with many cancers either showing no symptoms or presenting with vague signs. In the reproductive age group, the most typical manifestation is a benign functional cyst. Aim: To conduct a clinico-pathological analysis of adnexal masses among women presenting at a tertiary healthcare centre. Materials and Methods: A retrospective observational study was conducted in the Department of Obstetrics and Gynaecology at Akash Institute of Medical Science and Research Centre, Devanahalli, Karnataka, India, from November 2022 to April 2024. The diagnosis of adnexal mass was based on clinical symptoms, abdominal examination, bimanual examination, and trans-abdominal ultrasound. The CA-125 and other tumour markers were sent depending on the risk of malignancy. All tissues were sent for histopathological examination. The data were collected and tabulated in a Microsoft excel sheet, and percentages were calculated. Results: This study included 38 cases, in which benign ovarian and para-ovarian cysts were the most common findings, observed in 21 cases (55.3%). There were six cases of benign serous cystadenoma (15.8%), three cases of teratoma (7.9%), two cases of high-grade serous carcinoma (5.3%), one case of germ cell tumour (2.6%), one case of mucinous cystadenoma (2.6%), two cases of endometriotic cysts (5.3%), one case of adnexal cystic degeneration of a fibroid (2.6%), and one rare case of primary fallopian tube carcinoma (2.6%). The most common presenting complaint was abdominal pain, reported in 21 cases (55.3%). Conclusion: Adnexal masses can present in a variety of forms, ranging from benign cysts to infections and cancers. A thorough history and clinical examination are essential for accurate diagnosis. Investigations support the diagnosis, and histology confirms it.

We report a case of nodular melanoma. A 46-year-old female presented with a brown papule on the medial side of the right upper arm for more than 40 years, with an increase in size for 2 months. Dermatological examination revealed a demarcated brown fungoid nodule with crusts, 1.3 cm in diameter, on the medial side of the right upper arm. The nodule was surrounded by light erythema, without ulceration. Histopathology showed exophytic nodular growth, involving both the epidermis (Paget's cells) and the reticular dermis. The tumor cells appeared in epithelioid or spindle shapes with abundant cytoplasm, vesicular nuclei of varying sizes, prominent nucleoli, and mitoses (4/HP), arranged in a nest pattern. Breslow thickness was 10 mm, and Clark level was Ⅳ. Immunohistochemistry demonstrated S-100 (diffuse+), Melan-A(+), HMB-45 (focal+), Ki-67 hot spot area(25%+), SOX-10 (diffuse+), and PRAME (diffuse+).The diagnosis of nodular melanoma was made. The patient underwent an extensive excision. The patient was recommended to seek medical care in other facility. The latest follow-up showed that surgery and chemotherapy were not given after evaluation by the oncology department at other hospital.

Sava&scedil; Gegin,1 Ahmet Cemal Pazarl&inodot;,2 Burcu Özdemir,1 Levent Özdemir,1 Esra Arslan Aksu3 1Samsun Training and Research Hospital, Pulmonology Clinic, Samsun, Türkiye; 2Tokat Gaziosmanpa&scedil;a University, Faculty of Medicine, Department of Pulmonary Diseases, Tokat, Türkiye; 3Samsun University Faculty of Medicine, Pulmonology Department, Samsun, TürkiyeCorrespondence: Ahmet Cemal Pazarl&inodot;, Tokat Gaziosmanpa&scedil;a University, Faculty of Medicine, Department of Pulmonary Diseases, Tokat, Türkiye, Tel +90 5053696860, Fax +03562129500, Email dracp60@gmail.comAim: In cases where standardized maximum uptake (SUVmax) values in positron emission tomography (PET-CT) were not sufficient to differentiate mediastinal lymphadenopathy and masses from malignant or benign, the contribution of Hounsfield unit (HU) values in thorax computed tomography to the diagnosis was evaluated.Material Method: The study was conducted by evaluating the data of 182 patients between 2019 and 2023. HU values on non-contrast thorax computed tomography and PET-CT SUVmax values of biopsied masses and lymph nodes were compared with histopathological diagnoses.Results: Patients, 58 females (31.9%) and 124 males (68.1%), who underwent EBUS were included in the study. Biopsies were taken from 233 stations (199 lymph nodes, 34 masses) from 182 patients. A total of 135 of the biopsies taken from 233 stations were histopathologically malignant and 98 were benign. While PET-CT SUVmax values of cases with benign histopathology were 4.5 ± 3.5, it was 7.6 ± 4.2 in patients with malignant pathology (p< 0.05). The HU value on non-contrast thorax tomography in patients with benign histopathology was 43.1 ± 15.7, and in patients with malignant histopathology it was 40.5 ± 13.7 (p> 0.05). When HU was compared according to lung cancer type, it was found to be significantly higher in non-small cell lung cancer (p=0.035). A weak (r=0.182) positive and significant relationship (p< 0.01) was found between PET-CT values and HU values in thorax computed tomography.Conclusion: While positron emission tomography maintains its importance in the differentiation of mediastinal lymphadenopathy and masses from malignant to non-malignant, it was concluded that HU values in computed tomography are not sufficient to distinguish malignant/non-malignant.Keywords: Hounsfield unit, positron emission tomography, SUVmax, benign, malignant, mediastinal lymphadenopathy

Purpose: Aims to provide an overview of the contemporary epidemiology of malignant orbital tumors by analyzing population-based incidence patterns across various regions worldwide. Methods: In this article, we retrieved orbital malignancy data from the MEDLINE database and analyzed the incidence and prevalence of orbital malignancies worldwide. We performed the literature search by searching on the Mesh terms for malignant orbital tumors (''orbital'', ''tumor'', ''lymphoma'', ''malignant'', ''cancer'', ''incidence'', and ''epidemiology''). All included studies were published between 1993 and 2023 and were written in English. Results: Ocular or ophthalmic lymphoma most frequently occurred in the orbit, with a prevalence ranging from 47% to 54%. The incidence of malignant orbital tumors was increasing in the USA (2.0 per million (1981–1993), Netherlands (0.86 (1981–1985) to 2.49 (2001–2005) per million) and South Korea (0.3–0.8 per million (1999–2016)), respectively. Ophthalmic lymphoma which includes orbit lymphoma was increasing in Canada (0.17–1.47 per million (1992–2010)), Denmark (0.86 per million (1981–1985) to 2.49 per million (2001–2005)), respectively. Conclusions: The predominant primary malignant orbital tumor in adults was lymphoma. Ocular or ophthalmic lymphoma most frequently occured in the orbit. The limited data available suggested an increasing trend in the incidence of malignant orbital tumors in each country included, which were mainly attributed to the increase in lymphoma. Generally, incidence rates were found to increase with advancing age, with no difference between males and females.

Abstract Background Malignant chest wall tumors need to be excised with wide resection to ensure tumor free margins, and the reconstruction method should be selected according to the depth and dimensions of the tumor. Vascularized tissue is needed to cover the superficial soft tissue defect or bone tissue defect. This study evaluated differences in complications according to reconstruction strategy. Methods Forty-five patients with 52 operations for resection of malignant tumors in the chest wall were retrospectively reviewed. Patients were categorized as having superficial tumors, comprising Group A with simple closure for small soft tissue defects and Group B with flap coverage for wide soft tissue defects, or deep tumors, comprising Group C with full-thickness resection with or without mesh reconstruction and Group D with full-thickness resection covered by flap with or without polymethyl methacrylate. Complications were evaluated for the 52 operations based on reconstruction strategy then risk factors for surgical and respiratory complications were elucidated. Results Total local recurrence-free survival rates in 45 patients who received first operation were 83.9% at 5 years and 70.6% at 10 years. The surgical complication rate was 11.5% (6/52), occurring only in cases with deep tumors, predominantly from Group D. Operations needing chest wall reconstruction (p = 0.0016) and flap transfer (p = 0.0112) were significantly associated with the incidence of complications. Operations involving complications showed significantly larger tumors, wider areas of bony chest wall resection and greater volumes of bleeding (p

الملخص: أهداف البحث: تمثل الحليمات الكمئية الملونة في اللسان آفة مصبوغة نادرة التواجد وغير موثقة بشكل كاف في الدراسات المنشورة، مما يشكل تحديات في التشخيص وخطط العلاج اللاحقة. تهدف الدراسة إلى تحليل معرفة وفهم وموقف أطباء الأسنان تجاه أشكال الحليمات الكمئية الملونة في اللسان لتحديد التشخيص وخطط العلاج اللاحقة. طرق البحث: أجريت دراسة مقطعية بين أطباء الأسنان في جاوة الشرقية باستخدام استبانة عبر الإنترنت. تم تقديم أربع صور سريرية للحليمات الكمئية الملونة في اللسان، مع سبعة أسئلة لتقييم معرفة أطباء الأسنان بها، بما في ذلك نوع الآفة، وهياكل اللسان المتضمنة، وتصنيف هولزوانقر، ونمط الآفة، والتشخيص المشتبه به، وطبيعة الآفة (حميدة أو خبيثة). تضمنت أسئلة إضافية تجارب مع الآفة في الممارسة، والتحول المحتمل إلى الورم الخبيث، والتحقيقات التشخيصية، والعلاج المطلوب لتقييم المواقف. تم تحليل الفروقات في المواقف المرتبطة بالمعرفة إحصائيا باستخدام اختبار مان-ويتني. النتائج: شارك ما مجموعه 117 طبيب أسنان، وكانت الغالبية من الإناث (69.23%) ومن الفئة العمرية 26-30 سنة (44.44%). أظهر أطباء الأسنان الذين تتراوح أعمارهم بين 41-50 عاما معرفة متفوقة مقارنة بأولئك الذين تتراوح أعمارهم بين 20-30 عاما. أظهر الممارسون الذين لديهم 1-5 سنوات من الخبرة فروقات كبيرة في المعرفة حول هذه الحالة. لم يلاحظ تباين كبير بين مستوى المعرفة والموقف، خاصة فيما يتعلق بالعلاج والتحقيق الداعم. ومع ذلك، كان لمواجهة حالات الحليمات الكمئية الملونة تأثير كبير على قرارات العلاج والتحقيقات الداعمة. الاستنتاجات: يمتلك معظم أطباء الأسنان المشاركين مستوى جيد من المعرفة حول حالات الحليمات الكمئية الملونة. تتأثر معرفة أطباء الأسنان، كما يتضح من مواقفهم تجاه التحقيق والعلاج، بشكل ملحوظ بتجاربهم مع هذه الحالات. Abstract: Objective: Pigmented fungiform papillae of the tongue (PFPT) are infrequently encountered and inadequately documented pigmented lesions that pose challenges in diagnosis and subsequent treatment planning. The study was aimed at analyzing dentists' knowledge and attitudes regarding PFPT morphologies, to determine diagnosis and subsequent treatment planning. Methods: A cross-sectional study was conducted among dentists in East Java through an online questionnaire. Four clinical photographs of PFPT were presented, accompanied by seven questions assessing dentists' knowledge of PFPT, including lesion types, tongue structure involvement, Holzwanger classification, lesion patterns, suspected diagnoses and the nature of the lesion (benign or malignant). Additional questions to evaluate attitudes included prior experience with PFPT in practice, potential malignant transformation, diagnostic investigation and required treatment. Knowledge-associated attitude differences were statistically analyzed with the Mann–Whitney test with a threshold of p 0.05). However, prior encounters with PFPT cases were significantly associated with treatment decisions and supporting investigations for diagnosis (p

Background: Neck swellings are frequently found and can present the vast pathological spectrum from simple benign to highly malignant, which sometimes can pose a diagnostic dilemma. They are broadly classified as developmental, inflammatory, and neoplastic on the basis of etiology. The aim of the study is to assess the distribution of neck swelling according to etiology and its relation to age groups, as well as to assess their clinicopathological correlation as benign and malignant. Materials and Methods: The study was conducted from January 2020 to February 2023 on the basis of retrospective and prospective sampling. All the patients with neck swellings, except thyroid, who had undergone an excisional or incisional biopsy, were included in this study. Data was collected from in-patient records for retrospective sampling, and fine-needle aspiration cytology (FNAC), radiological investigation, and excisional or incisional biopsy were performed for prospective sampling after proper history and examination. Cytological and pathological correlation was analyzed as benign and malignant. Sensitivity and specificity were calculated. (P value

Background & Aims: Ovarian cancers are increasing in incidence, and an accurate ultrasonographic diagnosis, along with a complete physical examination and history taking, is essential for prompt diagnosis and early reporting. In this study, we aimed to evaluate the efficacy of ultrasonography (USG) in identifying ovarian lesions using histopathology as the gold standard. Materials & Methods: This was a retrospective study conducted by evaluating the reports of patients in the menopausal age group who had undergone total hysterectomy or oophorectomy. Histopathological diagnoses were retrieved from the Department of Pathology, and ultrasonographic (USG) reports were obtained from the patients' medical records. Results: This study included the histopathological and ultrasonographic reports of 239 women, of which 95.4% of cases were benign, while borderline lesions and malignant lesions constituted 3.3% and 1.3%, respectively. USG showed sensitivities of 93.55%, 66.7%, and 33% in identifying benign, borderline, and malignant lesions, respectively. Specificities of 91.67%, 91.84%, and 99.46% were noted in classifying ovarian lesions as benign, borderline, and malignant, respectively. Conclusion: Ultrasonography (USG) remains an important imaging tool for the early diagnosis of ovarian lesions, and a standardized reporting protocol should be implemented in every institution to increase the accuracy of USG and to reduce the inter-observer variability commonly encountered in ultrasound.

To evaluate the efficacy of radiomics features extracted from preoperative high-resolution computed tomography (HRCT) scans in distinguishing benign and malignant pulmonary pure ground-glass nodules (pGGNs), a retrospective study of 395 patients from 2016 to 2020 was conducted. All nodules were randomly divided into the training and validation sets in the ratio of 7:3. Radiomics features were extracted using MaZda software (version 4.6), and the least absolute shrinkage and selection operator (LASSO) was employed for feature selection. Significant differences were observed in the training set between benign and malignant pGGNs in sex, mean CT value, margin, pleural retraction, tumor–lung interface, and internal vascular change, and then the mean CT value and the morphological features model were constructed. Fourteen radiomics features were selected by LASSO for the radiomics model. The combined model was developed by integrating all selected radiographic and radiomics features using logistic regression. The AUCs in the training set were 0.606 for the mean CT value, 0.718 for morphological features, 0.756 for radiomics features, and 0.808 for the combined model. In the validation set, AUCs were 0.601, 0.692, 0.696, and 0.738, respectively. The decision curves showed that the combined model demonstrated the highest net benefit.

Introduction: The thyroid gland is a crucial endocrine organ that can be susceptible to various pathological conditions, often necessitating total thyroidectomy or lobectomy. It is a common surgical procedure in Saudi Arabia. Thus, it is essential to recognize the impact of thyroid surgery on patients’ health-related quality of life (HRQoL). Aim: The aim of this study was to evaluate HRQoL among patients with benign and malignant thyroid diseases who underwent thyroidectomy in the eastern region of Saudi Arabia. Methods: This cross-sectional study was conducted at King Fahad Hospital of University in Khobar, Kingdom of Saudi Arabia from January 2018 to May 2018. The data collection method used was divided into two parts. Part I included the patients’ socio-demographic characteristics and the clinical characteristics of their thyroid surgery. Part II was a HRQoL questionnaire (SF-36, version 1.0). Results: The sample included 100 thyroidectomy patients ≥18 years. The study findings revealed that the overall scores for post-thyroidectomy patients showed a significant improvement in HRQoL, and HRQoL was not significantly associated with benign or malignant thyroid diseases. Conclusion: Especially when the surgery is performed by a high-volume endocrine surgeon, thyroidectomy may lead to significant improvements in HRQoL among patients, including the elderly and younger adults, with benign and malignant thyroid disorders. There was no difference in HRQoL between patients who underwent total thyroidectomy or thyroid lobectomy. Also, HRQol among thyroidectomy patients is associated with their educational and occupational statuses.

Introduction: Merkel cell carcinoma is a very rare malignant neoplasm which presents high aggressivity, high recurrence rate and has meta-static potential. Our purpose is to present the histological and immunohistochemical particularities of Merkel Cell Carcinoma while reviewing potential differential diagnoses and challenges that we can encounter in daily practice.

Background: Malignant chest wall tumors need to be excised with wide resection to ensure tumor free margins, and the reconstruction method should be selected according to the depth and dimensions of the tumor. Vascularized tissue is needed to cover the superficial soft tissue defect or bone tissue defect. This study evaluated differences in complications according to reconstruction strategy. Methods: Forty-five patients with 52 operations for resection of malignant tumors in the chest wall were retrospectively reviewed. Patients were categorized as having superficial tumors, comprising Group A with simple closure for small soft tissue defects and Group B with flap coverage for wide soft tissue defects, or deep tumors, comprising Group C with full-thickness resection with or without mesh reconstruction and Group D with full-thickness resection covered by flap with or without polymethyl methacrylate. Complications were evaluated for the 52 operations based on reconstruction strategy then risk factors for surgical and respiratory complications were elucidated. Results: Total local recurrence-free survival rates in 45 patients who received first operation were 83.9% at 5 years and 70.6% at 10 years. The surgical complication rate was 11.5% (6/52), occurring only in cases with deep tumors, predominantly from Group D. Operations needing chest wall reconstruction (p = 0.0016) and flap transfer (p = 0.0112) were significantly associated with the incidence of complications. Operations involving complications showed significantly larger tumors, wider areas of bony chest wall resection and greater volumes of bleeding (p < 0.005). Flap transfer was the only significant predictor identified from multivariate analysis (OR: 10.8, 95%CI: 1.05–111; p = 0.0456). The respiratory complication rate was 13.5% (7/52), occurring with superficial and deep tumors, particularly Groups B and D. Flap transfer was significantly associated with the incidence of respiratory complications (p < 0.0005). Cases in the group with respiratory complications were older, more frequently had a history of smoking, had lower FEV1.0% and had a wider area of skin resected compared to cases in the group without respiratory complications (p < 0.05). Preoperative FEV1.0% was the only significant predictor identified from multivariate analysis (OR: 0.814, 95%CI: 0.693–0.957; p = 0.0126). Conclusions: Surgical complications were more frequent in Group D and after operations involving flap transfer. Severe preoperative FEV1.0% was associated with respiratory complications even in cases of superficial tumors with flap transfer. [ABSTRACT FROM AUTHOR]

Background: Due to a lack of routine, there is often uncertainty regarding diagnostics of tumours around the knee joint. This study aimed to provide knowledge about the frequency, distribution and diagnostic algorithm of different bone and soft tissue tumour entities of the knee at a large referral university hospital in Germany. Methods: Retrospective, longitudinal, single-centre study that reviewed adult patients from 2010 until 2020 with a suspected tumours diagnosis around the knee at a university cancer centre. Inclusion criteria were adults with true bone or soft-tissue tumours in the knee joint and in its adjacent compartments. Suspected diagnosis, histological tumour entity, localization and its surgical treatment by biopsy, resection, osteosynthesis or tumour endoprosthesis were investigated. Results: A total number of 310 adult patients were included with a mean age of 54.2 ± 18.8 years. In total 160 (51.6%) soft-tissue tumours (69/43.1% benign; 74/46.2% malignant; 17/10.6% intermediate), 92 (29.6%) primary bone tumours (46/50% benign; 39/42.3% malignant; 7/7.6% intermediate), 36 (11.6%) metastases and 22 (7.1%) lymphomas were detected. 171 (55.1%) tumours were classified as malignant. Suspected diagnosis was matched with histology in 74.5% (231/310) of all cases. In 6 cases a primarily suspected benign diagnosis turned out to be malignant. The majority of primary bone tumours was cartilage derived (63.1%;58/92) and located in the distal 2/3 of the femur, whereas intracapsular tumours of the knee joint were rare (13.0%). Soft-tissue tumours were located primarily in the middle third of the thigh (36.8%). The MRI was the diagnostic tool of choice in 98.1% of soft tissue tumours and 82.6% bone tumours. Conclusion: Awareness is crucial for detecting rare and malignant tumours around the knee, with adipocytic tumours being the most common soft tissue tumour and chondrogenic tumours as the most prevalent malignant bone tumour. Accurate diagnosis of bone tumours necessitates radiographs and frequently an additional MRI scan, while soft tissue tumours require mandatory MRI scans. Incorrectly diagnosing a tumour can have severe consequences, emphasizing the need for histological confirmation in all cases. Additionally, malignant tumours within joint capsules in adults are infrequent. [ABSTRACT FROM AUTHOR]

Objective. Differentiation of benign from malignant liver lesions. Methods: The main sources of data for the study are patients from the following teaching Hospitals attached to Bapuji Education Association, J.J.M. Medical College, Davangere. 30 patients with focal liver lesions and additional 10 healthy volunteers with no focal liver lesion were studied to know to know normal ADC of liver Result: Out of the total 85 focal liver lesions seen in 30 patients there were 63(74.1%) were malignant and 22(25.9%) were benign lesions. The number of malignant FLLs detected with DWI (62 out of 63 - 98.4%) was highly significant than that detected with T2 WI (P <0.001). However there was significant difference between the T2 weighted imaging and DWI for the detection of HCCs alone. This may be due most of HCCs were more than 2cm in size. However, there was no difference determined between T2 weighted imaging and DWI for the detection of benign hepatic lesions in our study. Mean ADC values obtained from normal liver parenchyma in benign and malignant group 1.25±0.04 x 10-3 mm² /s. and 1.23±0.06 x 10-3 mm² /s. respectively. Mean ADC of normal liver parenchyma (both benign and malignant group) was 1.24± 0.06 x 10-3 mm2 /s were not significant (ANOVA p=0.20). Conclusion: Cysts and hemangiomas had the highest ADC values while malignant masses had the lowest. The lowest ADC values among the malignant masses belonged to metastases. Mean ADC values of malignant lesions were significantly lower than those of benign lesions: 0.92 x 10-3 mm² /s V/s 2.68 x 10-3 mm² /s respectively (P< .001). The Sensitivity of 98 %( 61/62), Specificity of 100% with the ADC cutoff value 1.26 x 10-3 mm² /s was obtained by normal distribution (mean ± 2SD) for differentiating between benign and malignant liver lesions. [ABSTRACT FROM AUTHOR]

Introduction: The thyroid gland is a crucial endocrine organ that can be susceptible to various pathological conditions, often necessitating total thyroidectomy or lobectomy. It is a common surgical procedure in Saudi Arabia. Thus, it is essential to recognize the impact of thyroid surgery on patients' health-related quality of life (HRQoL). Aim: The aim of this study was to evaluate HRQoL among patients with benign and malignant thyroid diseases who underwent thyroidectomy in the eastern region of Saudi Arabia. Methods: This cross-sectional study was conducted at King Fahad Hospital of University in Khobar, Kingdom of Saudi Arabia from January 2018 to May 2018. The data collection method used was divided into two parts. Part I included the patients' socio-demographic characteristics and the clinical characteristics of their thyroid surgery. Part II was a HRQoL questionnaire (SF-36, version 1.0). Results: The sample included 100 thyroidectomy patients ≥18 years. The study findings revealed that the overall scores for post-thyroidectomy patients showed a significant improvement in HRQoL, and HRQoL was not significantly associated with benign or malignant thyroid diseases. Conclusion: Especially when the surgery is performed by a high-volume endocrine surgeon, thyroidectomy may lead to significant improvements in HRQoL among patients, including the elderly and younger adults, with benign and malignant thyroid disorders. There was no difference in HRQoL between patients who underwent total thyroidectomy or thyroid lobectomy. Also, HRQol among thyroidectomy patients is associated with their educational and occupational statuses. [ABSTRACT FROM AUTHOR]

Currently, cervical cancer (CC) is the fourth recorded widespread cancer among women globally. There are still many cases of metastatic or recurring disease discovered, despite the incidence and fatality rates declining due to screening identification and innovative treatment approaches. Palliative chemotherapy continues to be the standard of care for patients who are not contenders for curative therapies like surgery and radiotherapy. This article seeks to provide a thorough and current summary of therapies that have been looked into for the management of CC. The authors emphasize the ongoing trials while reviewing the findings of clinical research. Agents that use biological mechanisms to target different molecular pathways such as epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mammalian target of rapamycin (mTOR), poly ADP-ribosepolymerase (PARP), and epigenetic biological mechanisms epitomize and offer intriguing research prospects. [ABSTRACT FROM AUTHOR]

Background: Economic deprivation is expected to influence cancer mortality due to its impact on screening and treatment options, as well as healthy lifestyle. However, the relationship between insurance type, premiums, and mortality rates remains unclear. This study investigated the relationship between insurance type and mortality in patients with newly diagnosed cancer using data from the Korean National Health Insurance Database. Methods: this retrospective cohort study included 111,941 cancer patients diagnosed between 1 January 2007 and 31 December 2008, with a median follow-up period of 13.41 years. The insurance types were categorized as regional and workplace subscribers and income-based insurance premiums were divided into tertiles (T1, T2, and T3). Results: Cox proportional hazards regression analysis adjusted for age, lifestyle factors, health metrics, and comorbidities showed workplace subscribers (n = 76,944) had a lower all-cause mortality hazard ratio (HR) (95% confidence interval [CI]: 0.940 [0.919–0.961]) compared to regional subscribers (n = 34,997). Higher income tertiles (T2, T3) were associated with lower mortality compared to the T1 group, notably in male regional and workplace subscribers, and female regional subscribers. Conclusion: The study identified that insurance types and premiums significantly influence mortality in cancer patients, highlighting the necessity for individualized insurance policies for cancer patients. [ABSTRACT FROM AUTHOR]

Purpose: A skin lesion refers to an area of the skin that exhibits anomalous growth or distinctive visual characteristics compared to the surrounding skin. Benign skin lesions are noncancerous and generally pose no threat. These irregular skin growths can vary in appearance. On the other hand, malignant skin lesions correspond to skin cancer, which happens to be the most prevalent form of cancer in the United States. Skin cancer involves the unusual proliferation of skin cells anywhere on the body. The conventional method for detecting skin cancer is relatively more painful. Methods: This work involves the automated prediction of skin cancer and its types using two stage Convolutional Neural Network (CNN). The first stage of CNN extracts low level features and second stage extracts high level features. Feature selection is done using these two CNN and ABCD (Asymmetry, Border irregularity, Colour variation, and Diameter) technique. The features extracted from the two CNNs are fused with ABCD features and fed into classifiers for the final prediction. The classifiers employed in this work include ensemble learning methods such as gradient boosting and XG boost, as well as machine learning classifiers like decision trees and logistic regression. This methodology is evaluated using the International Skin Imaging Collaboration (ISIC) 2018 and 2019 dataset. Results: As a result, the first stage CNN which is used for creation of new dataset achieved an accuracy of 97.92%. Second stage CNN which is used for feature selection achieved an accuracy of 98.86%. Classification results are obtained for both with and without fusion of features. Conclusion: Therefore, two stage prediction model achieved better results with feature fusion. [ABSTRACT FROM AUTHOR]

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Although lung cancer has been recognized to be the deadliest type of cancer, a good prognosis and efficient treatment depend on early detection. Medical practitioners’ burden is reduced by deep learning techniques, especially Deep Convolutional Neural Networks (DCNN), which are essential in automating the diagnosis and classification of diseases. In this study, we use a variety of medical imaging modalities, including X-rays, WSI, CT scans, and MRI, to thoroughly investigate the use of deep learning techniques in the field of lung cancer diagnosis and classification. This study conducts a comprehensive Systematic Literature Review (SLR) using deep learning techniques for lung cancer research, providing a comprehensive overview of the methodology, cutting-edge developments, quality assessments, and customized deep learning approaches. It presents data from reputable journals and concentrates on the years 2015–2024. Deep learning techniques solve the difficulty of manually identifying and selecting abstract features from lung cancer images. This study includes a wide range of deep learning methods for classifying lung cancer but focuses especially on the most popular method, the Convolutional Neural Network (CNN). CNN can achieve maximum accuracy because of its multi-layer structure, automatic learning of weights, and capacity to communicate local weights. Various algorithms are shown with performance measures like precision, accuracy, specificity, sensitivity, and AUC; CNN consistently shows the greatest accuracy. The findings highlight the important contributions of DCNN in improving lung cancer detection and classification, making them an invaluable resource for researchers looking to gain a greater knowledge of deep learning’s function in medical applications. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between mediastinal fat and pulmonary nodule status, aiming to develop a deep learning-based radiomics model for diagnosing benign and malignant pulmonary nodules. We proposed a combined model using CT images of both pulmonary nodules and the fat around the chest (mediastinal fat). Patients from three centers were divided into training, validation, internal testing, and external testing sets. Quantitative radiomics and deep learning features from CT images served as predictive factors. A logistic regression model was used to combine data from both pulmonary nodules and mediastinal adipose regions, and personalized nomograms were created to evaluate the predictive performance. The model incorporating mediastinal fat outperformed the nodule-only model, with C-indexes of 0.917 (training), 0.903 (internal testing), 0.942 (external testing set 1), and 0.880 (external testing set 2). The inclusion of mediastinal fat significantly improved predictive performance (NRI = 0.243, p < 0.05). A decision curve analysis indicated that incorporating mediastinal fat features provided greater patient benefits. Mediastinal fat offered complementary information for distinguishing benign from malignant nodules, enhancing the diagnostic capability of this deep learning-based radiomics model. This model demonstrated strong diagnostic ability for benign and malignant pulmonary nodules, providing a more accurate and beneficial approach for patient care. [ABSTRACT FROM AUTHOR]

Background: Phyllodes tumor (PT), an uncommon fibroepithelial neoplasm accounts for less than 1% of all primary tumors of the breast. MPT with osseous differentiation often gets misdiagnosed on imaging as benign giant calcifications resulting in treatment delay. We describe a rare case of MPT with heterologous osteosarcomatous differentiation and osteoclast-like giant cells and review the literature to discuss clinical-radiological findings, differential diagnosis and treatment options. Case Presentation: A 34-year-old female presented with a right breast lump. Mammography showed a high-density irregular mass with amorphous dense calcification, suggesting neoplastic etiology. Preoperative core needle biopsy raised the possibility of a phyllodes tumor versus a giant cell tumor. A wide local excision was performed to confirm the diagnosis, which revealed the presence of a biphasic tumor with an osteoid-like matrix and numerous osteoclastic giant cells. Immunohistochemistry was used to rule out metaplastic carcinoma or carcinosarcoma. The stromal cells were negative for panCK and P63 and positive for vimentin, CD10 and BCL-2. The osseous component was positive for Osteonectin and SATB2. Thus, a final diagnosis of malignant phyllodes tumor with heterologous osteosarcomatous differentiation and osteoclast-like giant cells was made. Conclusion: MPT with osteosarcomatous differentiation is a rare and challenging entity associated with a poor clinical outcome. Accurate diagnosis requires a multidisciplinary approach involving breast surgeons, pathologists, and radiologists, along with careful histopathological examination. Wide local excision with close surveillance is crucial for the timely detection of tumour recurrence and metastasis. [ABSTRACT FROM AUTHOR]

Ovarian tumors can be challenging to diagnose and treat, especially in areas with limited access to advanced medical care. During routine prenatal ultrasounds, abnormal growths in the ovaries can be unexpectedly discovered. In clinical practice, it is essential to accurately differentiate between benign and malignant ovarian tumors in order to develop appropriate treatment plans. Ultrasound imaging has become the preferred diagnostic tool. The aim of this article is to examine the ultrasound characteristics of ovarian and adnexal growths and to explore how these characteristics, along with other clinical factors, can aid in predicting the likelihood of ovarian cancer. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine and compare the distribution, localization, breed, age and gender incidences of head and neck region tumors by years, by evaluating the results of dog-cat biopsies and/or operation material brought to Ankara University, Faculty of Veterinary Medicine, Department of Pathology between the years 2011 and 2021. In the study, 244 (15.9%) of 1533 tumors diagnosed in dogs and cats between 2011 and 2021 belonged to the head and neck region, of which 159 were in dogs and 85 in cats. Dogs with tumors were generally more than 6 years old (n=108) and cats were mostly 1 year old and older (n=75). In the head and neck region tumors observed in dogs, malignant and benign tumors of epithelial origin were most common (n=81; 50.9%), with sebaceous tumors (n=22) being the most common, and mostly observed around the eyes (n=26), while malignant and benign tumors of mesenchymal origin were most commonly found in the mouth region. Among the tumors of this region, epithelial tumors were mostly encountered in cats (n=39, 45.8%), and 51.2% of the epithelial tumors were squamous cell cancer (n=20), with epithelial tumors being the most common in the mouth (n=12) and nose (n=9). As a result, epithelial malignant and benign tumors were mostly seen in the eyes, and mesenchymal malignant and benign tumors were detected in the mouth. Among tumor types, papilloma in benign tumors and squamous cell carcinoma in malignant tumors were noted. [ABSTRACT FROM AUTHOR]